The company, which has added over 50 practices to the business this year alone, puts its success down to the group's family feel, and the 'hub and spoke' model it operates.
Arnold Levy, CEO at Medivet, said: "There are lots of things that have led to us being in the position we are now: our wonderful team and partners across the country, our passion for offering the best treatment, and the opportunities we offer vets wanting to run and own their practice."
"Much of that stems from our unique hub and spoke model. Without it, we wouldn’t be where we are – it really is central to all we do."
Medivet’s hub and spoke model is comprised of nine 24-hour centres (hubs) located around the UK with state-of-the-art facilities. The rest of the Medivet group consists of an integrated network of practices, or 'spokes'.
Medivet says the model allows smaller branches to offer pet owners services that otherwise wouldn’t be possible – referrals or specialist diagnostics, for example, can be passed on to another nearby practice or the bigger 'hub' if needs be.
Alison Jones heads up Medivet’s 200th practice in Gloucester and celebrated the opening in October with the practice team and other senior partners from Medivet.
Alison said: "The vast expertise in both the clinical and management fields that Medivet has to offer can take a huge strain off a busy practitioner. In addition, the inter-site communications, along with help via the Support Centre from a team of specialists in areas such as health and safety, employment law and marketing means each clinic can still operate as a local practice, but has the back-up of the whole Medivet team when needed.
"I have been impressed by how even the managers have not forgotten what it means to be a practising veterinary surgeon and have not lost their compassion for animals or passion for our profession. I feel I am working with people 'like me' and that makes me feel secure and understood."
The Targets Task Force comprises a leading veterinary surgeon and farmer from each of the beef, dairy, egg, fish, gamebird, pig, poultry meat and sheep sectors, who have been consulting with key organisations in their respective industries. The group also includes observers from regulators Food Standards Agency and Veterinary Medicines Directorate (VMD).
While the targets each sector has set vary according to the availability of data and scope in their sector, the targets as a whole have been described as 'positive and proactive' by the VMD.
The headline targets for the eight sectors include a reduction in use of antibiotics in pigs by over 60% between 2015 and 2020, with minimal use of highest priority Critically Important Antibiotics (CIAs). RUMA reports that good progress has already been made in this sector, with usage falling by around 35% between 2015 and 2016.
Targets Task Force member and president of the Pig Veterinary Society Mark White said: "It's encouraging to see the response in the sector to the challenge laid down, which bodes well for achieving our ambitious 2020 goal. It is evident that the sector – steered mainly by the members of the Pig Veterinary Society, AHDB Pork and the National Pig Association – has the will and the capability to fully engage with the issue."
Next steps, he said, were to focus on eliminating routine preventative treatment where it is still happening, mainly due to lack of resource or expertise. "We can also work to improve water delivery systems so that more targeted treatment in the water can be used instead of in-feed medication."
The dairy cattle sector has committed to a 20% reduction by 2020, with a particular focus on halving use of the highest priority CIAs. The work to achieve this will be led by a newly-created Dairy Antimicrobial Stewardship Group (DASG) which includes all key organisations in the sector.
Some of the strategies to achieve these goals in dairy farming include reducing the use of antibiotic dry cow therapy and injectable products, and cutting back on group treatments such as antibiotic footbaths for lameness which remain largely unproven, instead using topical and targeted treatments.
Di Wastenage, dairy farmer from Devon, Task Force member and chair of the DASG, said the sector needed to be ambitious about what it could achieve. “While use is lower than in some sectors, there are clear areas to tackle where use can be habitual, or common disease problems go unchallenged.
"For example, eliminating BVD and Persistently Infected animals from the herd is one of the obvious places to start, as well as talking to your vet to calculate the usage levels you have at the moment. Calf rearing can produce a 'hot spot' of treatment, as can digital dermatitis. Everyone has the potential to use antibiotics more responsibly somewhere."
The gamebird sector, having undergone a comprehensive awareness-raising initiative among game rearers in 2017 to cut back on reducing the need for medicines, aims to reduce use by a quarter this year, with a further 25% reduction between 2018 and 2020.
Three sectors – poultry meat, laying hen and fish – are either already low users of medicines or have made significant reductions over the past five years. These sectors will be focusing on maintaining use at the minimal level needed to ensure good health and welfare among their livestock, while tackling emerging challenges should they arise.
The poultry meat sector, previously described as a 'pathfinder' for the rest of the farming industry, has already reduced use by 71% between 2012, when its stewardship scheme was introduced, and 2016.
In doing this, the poultry meat sector has also ceased all preventative treatment and use of the highest priority CIAs. It will now maintain current levels in chickens and look for further reductions in turkeys. This sector will use clinical governance to ensure CIA antibiotics are only prescribed when absolutely needed and with sign off from veterinary specialists and management.
The laying hen and fish sectors have similarly committed to continuing low use, with the laying hen sector eliminating all use of highest priority CIAs in the past two years. The development of a vaccine in the salmon sector several years ago successfully controlled one of its most challenging bacterial diseases, so the focus has turned to the health of the ‘cleaner fish’ used to provide natural control of sea lice.
The trout farming sector, with its greater number of small producers, is concentrating on reducing the need for antibiotics and improving data capture.
The beef and sheep sectors are already low users of antibiotics, but have acknowledged they each need better data, and will also commit to addressing 'hotspots' of use. Both have committed to a 10% reduction in antibiotic use by 2020, subject to securing better data.
For the beef sector, reduction in use centres around calves and youngstock, particularly in the areas of respiratory disease. There is also an emphasis on calves from dairy herds, where mixing animals from different sources can create a peak in disease pressure similar to children going to school for the first time.
In sheep, the focus areas are to reduce routine preventative antibiotic usage against abortion (miscarriage), lameness and neonatal lamb diseases such as watery mouth and joint ill.
With initiatives proving that routine preventative use is largely avoidable through a combination of vaccination, good hygiene, quality nutrition and careful shepherding, Dr Fiona Lovatt of the Targets Task Force is optimistic about the opportunities to reduce overall use.
"In the sheep sector, we’re not high users of antibiotics. But we want to ensure that any use is totally targeted so we are challenging all inappropriate or routine preventative use.
"Convincing farmers to change practices is tricky, and none of us want to see an increase in levels of disease, but those who have had the courage to work with their vets to change what they do are now seeing what is possible. The answer is to take a holistic approach and work closely with a keen sheep vet."
Gwyn Jones, chair of both RUMA and the Targets Task Force, said he has been overwhelmed by the positivity of the group and its willingness to be ambitious. "The members have worked very hard and have shown incredible leadership and persistence. They have also provided unprecedented support and inspiration to each other.
"I am delighted they have agreed that the group should continue to meet twice-yearly to review progress and discuss issues."
The full report with all targets for each sector can be downloaded from the RUMA website www.ruma.org.uk.
Dubbed the PICO Project, the scheme will initially run via a series of specialism-specific surveys that let respondents select individual species or topics and input the research questions they would like to see covered within Veterinary Evidence.
Knowledge will make the list of submitted questions available online for the veterinary community to answer as Knowledge Summaries (Critically Appraised Topics), which will be peer-reviewed and published in the open-access journal.
Professor Peter Cockroft, recently appointed Editor-in-chief of Veterinary Evidence, said: "The practice of evidence-based veterinary medicine is an empowering process for practicing veterinarians that enables important gaps in knowledge to be identified. It is the bridge between research and clinical practice.
"If you have a clinical question that may shape the care of a patient, Veterinary Evidence may have the best current answer or will add the question to the growing archive of important information needs."
The first survey to launch – open now – will focus on equine practice, with possible subjects ranging from the likes of husbandry or vaccination to infectious diseases.
To ask for the evidence on a particular area, choose your topic in the survey’s drop-down menus and fill in up to five related questions, preferably in Population Intervention Comparison Outcome format.
Livestock will be the focus for the next survey, due to open alongside the BCVA Congress in October. Further surveys will look at canines, felines and other specialisms.
To keep up to date with the list of PICO questions being answered or available to be answered, visit Veterinary Evidence and follow @RCVSKnowledge on Twitter.
If you wish to become an author of a Knowledge Summary for publication in the journal, contact the Managing Editor at Bridget@rcvsknowledge.org.
Since 2014 the RCVS has trialled two different ADR services with the aim of helping resolve complaints between animal owners and veterinary practices that do not meet its threshold for serious professional misconduct.
Since October 2016, this has been in the form of the Veterinary Client Mediation Service (VCMS), administered by Nockolds Solicitors. The VCMS is free for both animal owners and veterinary professionals and cases will only be taken with the consent of both parties.
Eleanor Ferguson, RCVS Registrar, said: "We are very pleased that ADR in the form of mediation has received the unanimous support of RCVS Council members as part of the process for handling veterinary complaints.
"Throughout its trial period the VCMS has very much been complementary to our concerns investigation and disciplinary process. While we are bound by statute to investigate concerns, it has allowed our Professional Conduct Team to 'triage' cases, and to signpost complainants either to the College or the VCMS as appropriate. This has allowed greater time and resources to investigate concerns that could constitute serious professional misconduct.
"We also believe that the VCMS is good for both the public and the profession because it encourages both parties to communicate, find areas of agreement and come to constructive solutions, rather than being an adversarial process that assigns blame and adjudicates remedies."
Jennie Jones, a partner at Nockolds Solicitors which administers the VCMS, said: "The service is here to help veterinary clients and practices find a resolution for complaints that cannot be resolved within the practice. Complaints are referred to the VCMS by clients and practices where the relationship has become strained or communication may be difficult. Importantly the service does not look at who is right or wrong, but focuses on finding an outcome that both parties can live with and bringing an end to the complaint.
"In our experience this has ranged from reassuring clients and helping them to come to terms with what has happened, refunding fees, further explanations, apologies, small goodwill payments, securing procedural changes at the practice and agreement by the client to settle outstanding fees which have been withheld because of the complaint.
"We understand complaints are highly emotional and stressful for both parties, so the VCMS team will not ask parties to speak to one another directly. It is also not about assigning blame but is about moving forward to allow both parties to bring the complaint to a conclusion. When we hear from practices and clients alike that they can now sleep at night, or their relief that a complaint is resolved, I know ADR and the VCMS does help and make a difference."
The College says that during the trial period, 165 of the 870 enquiries received by the VCMS went to mediation. Of these, 129 were successfully mediated with the other 36 remaining unresolved. Of the other enquiries 297 resulted in the animal owner being referred back to the practice so that internal complaints processes could be exhausted first, 93 did not progress because the animal owner did not pursue the complaint, 73 were dealt with through advice, 66 did not progress as the practice declined to engage, 76 were outside the service’s remit and 100 are currently ongoing.
Taking into account the overall feedback received from both animal owners and veterinary professionals and the positive responses on the independence and fairness of the VCMS, Council agreed that Nockolds continue administering the scheme, with a review starting in 18 months’ time to take into account experience and learning as the scheme continues to evolve. During the Council meeting statements of support for the VCMS were also heard from a representative of the Veterinary Defence Society (VDS) and an independent consultant on consumer affairs.
A spokesperson for the VDS said: "The VDS assisted over 150 practices that agreed to participate in the ADR trial and developed a constructive working relationship with the VCMS staff. In the vast majority of cases mediation has resulted in a satisfactory outcome with little or no financial consequences.
"The Society considers this voluntary scheme particularly suited to the many client care complaints that are directed at the RCVS due to public misunderstanding of the College’s role, but the investigation of which creates disproportionate concern to the professionals involved. The independent nature of the VCMS has been a key feature of the trial, although access to experienced, non-judgemental, veterinary advice has provided the necessary professional expertise when necessary."
More information about the VCMS and its processes can be found on the service’s dedicated website: https://www.vetmediation.co.uk/
To contact the service directly call 0345 040 5834 or enquiries@vetmediation.co.uk
Participation in this year’s survey was similar to previous years with 5,235 people taking part and returning records for 15,433 horses. Most horses were kept in livery or a private yard and used for leisure and hacking and the majority within the age range of 5 to 10 years.
A broad variety of breeds were represented, including natives, thoroughbred types and warmbloods.
59% of horses were recorded as healthy and 41% with one or more health problems, compared to 62% and 38% respectively in 2016.
The top five disease syndromes recorded this year were:
Of the 5.5% of horses recorded with back problems 26% were also showing signs of lameness. While the details of the results do not confirm that the two are necessarily connected, these findings reflect the outcome of recent studies conducted by Dr Sue Dyson, Head of Clinical Orthopaedics at the Centre for Equine Studies at the Animal Health Trust.
Sue said: "It is a common observation that horses with lameness stiffen the back as a protective mechanism and develop muscle pain which may be misinterpreted as a primary back problem. We have shown objectively that abolition of lameness by diagnostic analgesia results in an immediate increase in range of motion of the back. The current data supports this close relationship between lameness and back pain."